When Chrispine Jacob lost both of his parents to HIV, he almost lost his lifelong dream of becoming a doctor, too. Although he enrolled at a local school, his guardians struggled to pay tuition.

“When I joined [the school], life was a bit difficult,” says Jacob, who lives in Western Kenya, one of the country’s poorest regions. “I was sent home several times to look for money.”

Things changed for Jacob when he became part of a community-based program that supports orphans and vulnerable children. With his tuition and some of his other expenses covered, he gained a new chance to realize his dream.

The program is just one part of a wide-reaching project led by PATH called AIDS, Population, and Health Integrated Assistance Zone 1—or APHIAplus Western for short. Through a broad portfolio of integrated activities, APHIAplus Western allows us to work across the health system to help some of Kenya’s most vulnerable people.

Community response to challenges

Western Kenya is one of the most densely populated areas of the country. It faces a high burden of HIV/AIDS, malaria, tuberculosis, and other infections and diseases. The challenge is compounded by poverty, poor health information, and harmful social norms, such as HIV stigma and gender-based violence. Together, these issues have undermined communities and left large numbers of people in need of care and support.

To meet this challenge, PATH is collaborating with partners including The Elizabeth Glaser Pediatric AIDS Foundation, Jhpiego, World Vision, Mildmay, and Broad Reach Health Care on APHIAplus Western, an initiative funded by the United States Agency for International Development. The project combines dozens of community-based programs to increase people’s use of prevention and care services for HIV and related issues, including tuberculosis, family planning, maternal and child health, reproductive health, and malaria.

APHIAplus Western builds on the success and experience we gained through a similar effort called APHIA II. When that project ended in 2010, we had surpassed our goals and improved care and treatment for thousands of people. For example, we reached:

About 51,000 people with antiretroviral therapy.

Nearly 703,000 people with information about HIV/AIDS.

More than 13,000 HIV-positive pregnant women with antiretroviral prophylaxis, which helps to prevent the transmission of HIV to their children.

Almost 400,000 pregnant mothers with HIV/AIDS counseling and testing services.

APHIAplus allows us to expand our lifesaving work to reach even more people.

A focus on pregnant women

For example, we are continuing our efforts to strengthen care for women in Western Kenya, who often don’t have the power to seek services for themselves or their children. One of these projects, the community-based boda boda (motorcycle) ambulance service, helps pregnant women in remote communities reach skilled care in time to give birth. This improves health outcomes and lowers rates of mother-to-child transmission of HIV. The service provides a modest stipend to drivers, who drive expectant mothers to health facilities.

Simple, community-based programs like the boda boda ambulance and the school fees program are just two examples of how we’re helping people transform their lives in Western Kenya.

Addressing health from every angle

Because good health relies on a variety of factors, we take a whole system approach to our work. Support for health facilities helps improve and expand care for HIV, tuberculosis, and malaria and prevent mother-to-child transmission of HIV. Training helps health care workers prevent, diagnose, and treat disease. Creative communication and community engagement programs reduce HIV stigma, change behavior that can lead to gender-based violence, and encourage people to seek care. Targeted programs improve services for adolescents and other marginalized groups. And literacy programs, household income initiatives, and other services address the economic and social inequities that contribute to poor health. Linking these services to one another and to the larger health system makes the most of limited resources and achieves the most improvement.

Together, these efforts are transforming health and empowering communities in Western Kenya, and building the foundation for sustainable and lasting change.